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Back into the swing

Fall 2014

Sitting in the peacefulness of his backyard, Herb Hunter crosses his legs casually and leans back into his chair, a vision of comfort and contentment. These days, he says he’s “living the life of Riley” and enjoying retired life the way it’s meant to be: relaxed, healthy and pain-free, with each day full of possibilities. It’s hard to imagine that only a few years ago, at 57 years young, Hunter was immobilized by the painful grip of osteoarthritis.

Affecting more than three million Canadians, osteoarthritis is the most common form of arthritis and can be caused by normal ‘wear and tear’ on joints as a person ages. With osteoarthritis, cartilage begins to wear away and the bone-on-bone movement of the affected joint leads to pain, stiffness and swelling.

“It was just agony,” Hunter says of the pain that radiated from his hips through his legs. “I was teaching then and I liked to move around the classroom and check on my students, but I started noticing that I wasn’t up as much as I should have been.”

Even the most ordinary activities, such as rolling over in bed or putting on socks, caused Hunter excruciating pain. He quickly came to realize that without intervention, he would be headed towards a frighteningly familiar future. Hunter had watched his grandfather become confined to a wheel chair and his father restricted to canes and crutches. Hunter decided not to take the pain lying down. He met with LHSC’s Dr. Steve MacDonald, orthopaedic surgeon, who sees many patients like Hunter every year.

“Orthopaedics is the largest division in the Department of Surgery and the size of it speaks to the lifestyle change that joint replacement can bring, as well as the significant positive impact of our other clinical teaching units of sports medicine, spine, trauma and paediatrics,” says Dr. MacDonald. “We do just shy of 2,000 hip and knee replacements each year and 98 per cent those are due to osteoarthritis.”

Hip replacement surgery is becoming more common. While the average age of patients receiving joint replacement is between 63-65 years old, demographic is widening, with both younger and older patients requiring such surgery.

“Thanks to improvements in the quality of artificial joints, the comfort zone in dealing with the younger patient is higher,” explains Dr. MacDonald. “We have more and more elderly patients as well because patients are living longer, and now, the baby boomer demographic, which is the largest in the population, is marching through needing knee and hip replacements.”

“With the Baby Boomer generation, we see an increased proportion of the population reaching the typical age where joint replacement is needed, so our volumes are increasing every year. As well, we are increasingly performing joint replacements for younger patients like Herb who want to maintain their active lifestyle.”

For Hunter, hip replacement surgery was required for both hips, but each would be completed separately. According to Dr. MacDonald, about 30 per cent of patients who get one hip replaced will also require the other hip to be replaced at some point in the future.

While Hunter expresses the decision to move forward with any surgery should only be made after deep consideration, his decision to ‘go for it’ was still an easy one.

“I know that some people are afraid of surgery,” he says. “But I’ve always believed that in life there are critical moments, and in those moments you are going to make a decision that impacts your life in a positive way or in a negative way. Having this operation was the decision that changed my life because if I had continued that way – there was no life.”

Recovery from each hip replacement surgery took Hunter about three months, but the reduction of pain was instant.

“I remember waking up [from surgery] and thinking that the pain in my hip was gone,” he says. “Sure, I had some pain associated with surgery, but that was manageable.”

But that’s not to say that the surgery was without a few new experiences.

“I think my most vivid memory of the whole thing was the physiotherapist coming in and asking me if I could lift my leg off the bed and I couldn’t. I thought I was done! But then she went and got a device with two electrodes and told me to lift my leg off the bed. When she applied the electronic pulse, my leg moved! It was an amazing experience. The muscle memory returned very quickly – and the care was great. They take care of you.”

Through setting moderate goals and completing physiotherapy exercises regularly Hunter was able to return to a quality of life that he hadn’t experienced in years. In fact, he played 110 rounds of golf last year alone and still enjoys being active in the gym and outdoors.

“I have absolutely no pain,” he explains. “I go to the gym every day, I row, I use the elliptical, I walk on the treadmill, and I do spinning classes. I’m very, very fortunate.”

He has also become an advocate for joint replacement surgery.

“I can spot people with hip issues now, just because I know that walk” he says. “To anyone suffering with that pain, I say ‘don’t wait … see your specialist.’”

And for those wondering about the longevity of the results, Dr. MacDonald emphasizes the significance of the improvements that have been made in the quality of the materials used in artificial joints.

“Around the year 2000 the companies changed the formula of the plastic liner, which was the part that used to wear out. We’re following patients out 14 years now [post-replacement] and we can’t even see wear of the newer plastic on an x-ray. Considering the average age of a typical patient is around 65, for most, their hips will last them a lifetime.”

Since his last hip surgery in 2001, Hunter has been returning to LHSC for check-ups and remains pleased with the results.

“Dr. MacDonald is a hero to me because he gave me my life back. I’m proud that I had this operation and I’m grateful that I have the quality of life that I do.”

London Health Sciences Foundation's generous donors are advancing the standard of care for patients across London and southwestern Ontario through their support for Orthopaedic Care.

LHSC is a Canadian and international leader in this important field, offering a broad range of services, including joint replacement, spine care, paediatric care, trauma care (as the regional trauma centre) and sports medicine. In 2014, LHSC's Fowler Kennedy Sport Medicine Clinic celbrated 40 years of helping people stay active.